LAKE COUNTY INTERNAL MEDICINE ASSOC LLC (NPI# 1316434376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316434376 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTY INTERNAL MEDICINE ASSOC LLC |
| Practice Address |
15 Tower Ct. Ste 190 Gurnee IL 60031 |
| Mailing Address |
200 Rittenhouse Circle East Building Ste 5 Bristol PA 19007 |
| Practice Telephone | 8885900808 |
| Practice Fax Number | 8667404689 |
| Mailing Telephone | 8885900808 |
| Mailing Fax Number | 8667404689 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |
| Authorized Official Name | MACKENZIE HAHN (NCPDP COORDINATOR) |
| Authorized Official Telephone | 8885900808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 036093940 | IL | Suppliers |
| Street Address |
15 TOWER CT. STE 190 |
| City | GURNEE |
| State | IL |
| Zip Code | 60031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| 1801167309 | Emily Anne Eichmeier | Social Worker | 4212 Old Grand Ave. Gurnee Counseling, Suite 102, Gurnee, IL 60031 | 2012-01-16 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013520113 | Pmr Illinois Holding, LLC | Non-Pharmacy Dispensing Site | 600 E Sibley Blvd, Dolton, IL 60419-2599 | 2020-08-28 |
| 1386255123 | Dermatology Associates Ltd | Non-Pharmacy Dispensing Site | 13401 S Ridgeland Ave, Palos Heights, IL 60463-1898 | 2020-08-14 |
| 1497398648 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 853 W Jackson Plaza, Morton, IL 61550 | 2019-10-21 |
| 1902449382 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1730 Bradford Ln, Normal, IL 61761-1297 | 2019-10-18 |
| 1073173134 | Shobhana Patodia | Non-Pharmacy Dispensing Site | 1111 Superior St Ste 206, Melrose Park, IL 60160-4156 | 2019-06-19 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
| 1124585534 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5209 W. War Memorial Drive, Grand Prairie Mall, Peoria, IL 61615-9250 | 2019-02-22 |
| 1871050237 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 508 Iaa Dr, Bloomington, IL 61701-2216 | 2019-02-21 |
| 1518424969 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2901 Columbus St, Ottawa, IL 61350-1009 | 2019-02-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.